Drainless mastectomy: Is it safe and effective?

Practice regarding the use of post operative drains after simple mastectomy varies widely. This project aimed to establish if not using a drain lead to an increase in post-operative seroma formation or other complications. Methods: Women undergoing simple mastectomy +/- sentinel node biopsy were included. Patients were allocated to drain/no drain group via operating surgeon. Data was collected retrospectively from computer based records. Drain output, length of stay, seroma formation and volume and post-operative complications were recorded. Results: There were 39 patients in the drain group and 24 patients in the no drain group. Patients did not differ significantly in terms of age, BMI or specimen weight. Seroma was more prevalent in the no drain group (62 v 83%) and required more clinic attendances for aspiration with larger volumes drained (360 vs 725 ml, p = 0.0096). There was no difference in overall complication rate. There did not appear to be a correlation between seroma formation and age, BMI or mastectomy weight. Conclusions: The use of a drain after simple mastectomy may confer lower rates of seroma formation as well as lower overall volumes. Therefore drainless mastectomy appears to be safe but may require more post-operative intervention. (C) 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.